Granulomatous lymphadenopathy secondary to phenytoin therapy

Though rare, long term use of phenytoin has been associated with various lymphatic system disorders like pseudolymphoma, Hodgkin lymphoma and non Hodgkin lymphoma. Histopathological changes in phenytoin induced lymphadenopathy may be heterogenous and non specific as well. Phenytoin induced pseudo lymphoma syndrome may show histopathological findings similar to mycosis fungoides and may take a prolonged course even after the cessation of the drug. This case report is about the development of granulomatous lymphadenopathy secondary to long term use of phenytoin, which regressed completely after discontinuation of the drug. The case is being reported because granulomatous pathology may lead to misdiagnosis and management issues if not correlated with phenytoin therapy in such instances.